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A male client is being seen by a physician at a community clinic regarding a painless ulcer on his penis. The provider will be communicating his diagnosis of syphilis and prescribing treatment. In the primary stage of syphilis, what is the time between infection and development of symptoms?
- A. 7 days
- B. 10 days
- C. 21 days
- D. 35 days
Correct Answer: C
Rationale: The correct answer is C: 21 days. The primary stage of syphilis typically occurs around 21 days after infection when a painless ulcer, known as a chancre, appears at the site of infection. This is due to the multiplication of the bacterium Treponema pallidum. Choice A (7 days) is too short for the development of symptoms. Choice B (10 days) is also too short. Choice D (35 days) is too long for the primary stage of syphilis.
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A client is being treated for gonorrhea. Which medication combination should the nurse expect to be prescribed?
- A. Ceftriaxone and azithromycin
- B. Penicillin and ceftriaxone
- C. Tetracycline and azithromycin
- D. Levofloxacin and azithromycin
Correct Answer: A
Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone is the first-line treatment for gonorrhea due to increasing resistance to other antibiotics. Azithromycin is often prescribed in combination to treat possible co-infection with chlamydia. Penicillin (B) is not effective against gonorrhea. Tetracycline (C) is not recommended due to resistance issues. Levofloxacin (D) is no longer recommended due to resistance concerns. The combination of ceftriaxone and azithromycin covers both gonorrhea and possible chlamydia co-infection effectively.
An absence of what may facilitate the occurrence of bacterial vaginosis?
- A. Antibodies
- B. Lactobacillus acidophilus
- C. Gardnerella vaginalis
- D. Vaginal mucosa
Correct Answer: B
Rationale: Correct Answer: B - Lactobacillus acidophilus
Rationale: Lactobacillus acidophilus is a beneficial bacteria that helps maintain the acidic pH of the vagina, inhibiting the growth of harmful bacteria like Gardnerella vaginalis. An absence of Lactobacillus acidophilus can disrupt the vaginal microbiota balance, allowing for the overgrowth of harmful bacteria and leading to bacterial vaginosis.
Summary of Incorrect Choices:
A: Antibodies - Antibodies play a role in the immune response but are not directly related to the occurrence of bacterial vaginosis.
C: Gardnerella vaginalis - Gardnerella vaginalis is a bacteria associated with bacterial vaginosis, not its absence.
D: Vaginal mucosa - The integrity of the vaginal mucosa is important for protection, but its absence would not directly facilitate bacterial vaginosis.
A client has an HSV-2 infection. The nurse recognizes that which of the following should be included in teaching the patient?
- A. The virus causes cold sores of the lips.
- B. Treatment is focused on relieving symptoms.
- C. The virus is cured with antibiotics.
- D. The virus is transmitted only when visible lesions are present.
Correct Answer: B
Rationale: The correct answer is B because HSV-2 is a sexually transmitted infection that causes genital herpes. Treatment focuses on managing symptoms like antiviral medications, not curing the virus. Explanation of other choices: A is incorrect because HSV-2 causes genital sores, not cold sores on the lips. C is incorrect because antibiotics do not cure viral infections. D is incorrect because HSV-2 can be transmitted even when there are no visible lesions through asymptomatic shedding.
A nurse is providing preoperative teaching for a woman who is undergoing a total mastectomy. Which will this teaching include? Select all that apply.
- A. Explain that she will have an IV, a drain, and a dressing in place on awakening. Tell her about expectations she may have regarding physical appearance, pain management, equipment that will be used (IVs, drains, etc.).
- B. Explain that she will be provided pain management as needed; monitor and review the pain scale to be used to identify level of intensity.
- C. Have her elevate the affected arm with pillows.
- D. Turn the woman every 4 hours, alternating between the unaffected side and affected side. To prevent pneumonia and complications, have her cough and take deep breaths every 2 hours, while nurse applies support to the chest.
Correct Answer: C
Rationale: Rationale for Answer C (Correct Answer):
1. Elevating the affected arm with pillows post-mastectomy helps reduce swelling and promote lymphatic drainage, aiding in preventing lymphedema.
2. By elevating the arm, it reduces strain on the surgical site and surrounding tissues, promoting comfort and aiding in the healing process.
3. This positioning also helps in preventing postoperative complications such as shoulder stiffness and contractures.
Summary of Why Other Choices are Incorrect:
- Choice A: While important aspects of preoperative teaching, it does not specifically address the need to elevate the affected arm post-mastectomy.
- Choice B: Pain management is crucial, but it does not directly relate to the need for arm elevation post-mastectomy.
- Choice D: Turning every 4 hours and coughing exercises are important for preventing complications but do not address the specific need for arm elevation post-mastectomy.
The client calls the nurse and states she has not had a menstrual cycle in 3 months. What does the nurse know is the most common cause of secondary amenorrhea?
- A. Weight loss
- B. Pregnancy
- C. Cancer
- D. Menopause
Correct Answer: B
Rationale: The correct answer is B: Pregnancy. In the case of secondary amenorrhea, where a woman stops menstruating after previously having regular cycles, pregnancy is the most common cause. Pregnancy leads to a halt in the menstrual cycle due to hormonal changes to support the developing fetus. Other choices are incorrect: A) Weight loss can affect menstruation but is not the most common cause of secondary amenorrhea. C) Cancer can also disrupt the menstrual cycle, but it is not the primary cause in this scenario. D) Menopause typically occurs in women in their late 40s to early 50s, and would not be the most common cause of secondary amenorrhea in a younger woman.